Parturition at term in the American Journal of Obstetrics & Gynecology

There are 140 million births per year worldwide, and childbirth is a defining moment in anyone’s life.¹ Largely a physiologic process, parturition does come with risks; one mother dies every two minutes.² These deaths occur mostly in healthy women and are often considered preventable.^2,3 For each death, 20 to 30 mothers experience complications that compromise their short- and long-term health.^4,5 The risk of birth extends to the newborn, and, in 2020, 2.4 million neonates died, 25% in the first day of life.⁶ Therefore, intrapartum care should be an important priority for society. To this end, the American Journal of Obstetrics & Gynecology (AJOG) will devote two special supplements to the clinical aspect of labor at term.

The articles in this first supplement address birth plans, birth settings, the role of midwives in intrapartum care, methods to assess labor progress, the diagnosis of labor disorders in the first stage, the nature of pain during labor, and the pharmacologic and nonpharmacologic means for pain relief. Authors also review methods of monitoring uterine contractility and frequent complications such as intrapartum fever and abruptio placenta.

The opening article of this issue discusses “the importance of listening to mothers to transform maternity care” and is authored by the leadership of “Every Mother Counts,” an organization dedicated to making pregnancy and childbirth safe, respectable, and equitable for every mother, everywhere. This choice reflects my view that mothers should be at the center of any conversation related to childbirth.

The second supplement of AJOG devoted to labor at term, to be published later this year, will address issues related to the induction of labor, intrapartum sonography, assisted vaginal delivery, and care during the second and third stages of labor.

To ensure that information about parturition reaches as many people as possible, we have made all articles freely available to subscribers and non-subscribers, thanks to the generosity of our publisher, Elsevier, Inc. Articles are accompanied by videos summarizing the key concepts and are posted to AJOG’s social media channels—Twitter, Instagram, Facebook, and a dedicated YouTube channel. Dr Christopher Robinson, AJOG Social Media Editor, oversees this important activity. Our goals are that health care providers as well as mothers and their families find the information needed to optimize intrapartum care and that no complications would occur because of a lack of access to knowledge about parturition. With the tools of the information age, we hope to reach people in all corners of the world.

The ideas for these supplements emerged from conversations with the Guest Editors, among whom is Dr Emanuel Friedman, who published the first graphic analysis of labor on the pages of AJOG in 1954.⁷ From that initial set of observations emerged the partogram, the different phases of labor, and a nomenclature of labor disorders.⁸ Dr Friedman is accompanied by a group of prominent obstetricians—Dr Anthony Vintzileos, Dr Joanne Stone, Dr Luis Sanchez-Ramos, Dr Sonia Hassan, Dr Alison Cahill, and Dr Huixia Yang. They bring unique expertise and experience in intrapartum care and have contributed as editors, reviewers, authors, or consultants.